section 4 reimbursable mealssquaremeals.org/portals/8/files/training/dch/05-dch12-reim meals.pdf ·...

Section 4

Reimbursable Meals

Introduction to Child and Adult Care Food Program Day Care Home Sponsors

Reimbursable Meals 4 - 1

Section 4 – Reimbursable Meals

Cornerstone of the Program The serving of meals that meet requirements is the cornerstone of the CACFP program. All meals served by your providers must meet specific criteria regarding components and minimum serving amounts. To assist sponsors (and their providers) in planning meals that meet requirements, USDA FNS developed a set of meal patterns that outline what components must be served at each meal service as well as the minimum serving sizes that must be served, based on the age of the child. TDA is committed to the 3E’s of Healthy Living – Education, Exercise and Eating Right. As part of this commitment, the CACFP initiative “Promoting Healthy Eating and Physical Activity for a Healthier Lifestyle” is TDA F&N’s avenue to promoting a healthier lifestyle, including healthy eating and physical activity for children ages 2 – 5 years. The initiative includes recommended modifications that are voluntary but if DCH providers implement these minor changes to the meal patterns, they will lower total fat, saturated fat, trans fatty acids, added sugars and calories. At the same time, they will increase fruit, vegetable, Vitamins A and C, fiber and whole grain consumption. NOTE: The modifications recommended do not replace the component and serving size requirements in the CACFP Meal Patterns.



Advance Planning of Meals Sponsors should encourage their providers to plan meals at least two weeks in advance of a meal service to assist in:

� Food-purchasing (watch for sales); � Cost control (a benefit of catching sales); and

� The scheduling of food preparation.

Successful sponsors always review their providers’ menus in advance to reduce the number of disallowed meals. In other words, your prior review of their menus will help you spot poorly planned meals that would not meet requirements had they been served. Prior review of your providers’ menus also enables you to suggest foods that the provider may not have thought about using. For example, children’s diets often lack sufficient nutrients such a iron and vitamins A and C. If you notice that a provider is not serving foods rich in these nutrients, you might suggest their serving those types of food.

Menu Planning Sponsors cannot require the use of pre-planned, pre-printed menus – or – provide pre-planned, pre-printed menus, except as training tools. Always ensure that your providers prepare a menu record for each meal service on a daily basis. If providers choose to use pre-planned, pre-printed menus that they have developed, they must:

� Verify that the items on the pre-printed menu were served (or that an acceptable substitute was used);

� Identify the individual who recorded the information; and

� Record the date.



Example: A provider is using a pre-printed 10-day menu. On day one of this 10-day cycle, the provider served all the items as listed. Prior to the end of the day, the provider must notate that each item was served and initial and date the menu record. Example: If a provider runs out of green beans and must substitute corn in its place, the provider would strike through the words “green beans” on the menu and record “corn” and also notate that all other items were served. Initialing and dating the menu would complete it. Cycle Menus Cycle menus repeat themselves over a period of time, usually three to six weeks. Using cycle menus provides a variety of meals, reduces cost, and makes it easier for providers to plan their children’s favorite food combinations. Therefore, you should encourage the use of these menus with your providers.

CACFP Meal Patterns There are distinct meal patterns for all children in care, ranging in age from infancy to 12 years of age. Important! It is critical that you provide meal pattern training and technical assistance with all of your providers. If they are unfamiliar with the food components and minimum serving sizes mandated, they will be unable to create menus that will meet requirements. Training and/or technical assistance in menu-planning and the meals patterns must be given to:

� New providers;

� Problematic providers; and

� All providers to some degree annually.



Let’s Take A Look At the Meal Patterns On the following pages we will look at the meal pattern charts and cover the most important points. Remember, there are recommended modifications that can be made such as serving juice only once daily and serving ready-to-eat cereals with no more than 10 grams of sugar per serving, but these are not mandatory.



Important Infant Meal Pattern Information

Infant formula and infant cereal must be iron-fortified. The sponsor/provider must offer at least one brand choice that meets requirements. In some cases, the parent/guardian will decline the use of the formula and will bring his or her own. Be sure to document that the parent has declined the brand you offer. If the brand the parent brings meets program requirements then the meal can be claimed. If a child has a disability or special dietary need, a medical statement is required for you claim the substitutions indicated. A listing of iron-fortified infant formulas that do not require a medical statement is at the following website: http://www.fns.usda.gov./cnd/Care/Regs-policy/infantmeals/FormulaList.htm.

Regarding Infant Meal Pattern for Lunch/Supper: In the 8 to 11 months age group, you must serve formula or breast milk, the serving of fruit/vegetable, and either the serving of cereal or meat/meat alternate indicated on page 4-5. All three component groups for the 4 to 7 month-old children can be served based on the child’s developmental readiness. Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) You are required to distribute information regarding the WIC program annually to households with children enrolled in your sponsored day care homes. There are flyers available in English and Spanish that you can download at www.snptexas.org



Note: Breakfast consists of three components: a serving of milk, a serving of fruit or

vegetable, and a serving of grains/breads. Notice also that servings increase in each age group.



Note: For lunch or supper, the meal pattern mandates two different servings of fruit or

vegetable, continues the milk and grains/breads requirements, and adds a serving of meat/meat alternate.



Pick two of the four components but DO NOT serve two liquids.



Water Availability

Potable (suitable for drinking) water must be made available throughout the day, including meal times, for children to drink upon their request, but does not have to be available for self-serve.

Even though water must be made available during mealtimes it not part of the reimbursable meal and cannot be served in lieu of fluid milk.

Fluid Milk and Fluid Milk Substitutions

Fluid milk served to children ages two or older must be:

• Fat-free or low-fat milk • Fat-free or low-fat lactose reduced milk • Fat-free or low-fat lactose free milk • Fat-free or low-fat buttermilk

• Fat-free or low-fat acidified milk

The milk served must be pasteurized fluid milk that meets State and local standards and may be flavored or unflavored. Whole milk and reduced-fat (2%) milk may not be served to children over two years of age.

NOTE: Child Care Licensing does not allow the use of sweetened (flavored) milk.



Meal Patterns and the Food Buying Guide “FBG” As a sponsor of the CACFP DCH Program, you must know how to use a USDA-published document entitled the “Food Buying Guide for Child Nutrition Programs” otherwise known as the “FBG.” Your providers must serve meals that meet meal pattern requirements in order to be reimbursable. The meal patterns outline:

� Components required in each meal; and

� Minimum amount of each

component that must be served. When you train your providers in menu planning, meal preparation, and the other basics related to providing meals to children, you will need a knowledge of the FBG; in particular, the foods listed in it that are “creditable foods”. “Creditable foods” are those foods that USDA/FNS has approved for serving in the Child Nutrition Programs. All of these creditable foods are listed in the FBG. The guide covers all food component groups:

� meat/meat alternates; � fruits/vegetables; � grains/breads; � milk; and � other foods that are non-creditable but frequently used to

enhance the creditable foods. Sponsors frequently use the FBG to train new providers in the foods that are creditable and those that are not. On the next page, there is a sample page from the Meats/Meat Alternate section. The most updated version of the FBG is found at http://www.fns.usda.gov/tn/Resources/foodbuyingguide.html



Another Valuable Training Resource

The National Food Service Management Institute website (home page shown below) has an extensive collection of training formats that sponsors of the DCH and others can use for training their staff. Training formats include menu-planning, food safety, recipe development and standardization, and many, many others. Go to: http://www.nfsmi.org/



Meals for Children with Disabilities Day Care Home providers must provide special meals or substitute individual components for children who have:

� A disability that restricts their diet; and

� Provided the appropriate documentation. Children who have a food allergy that results in anaphylactic shock, a severe life-threatening reaction when exposed to the allergen, are considered "disabled" and are therefore entitled to dietary substitutions as prescribed by a licensed medical authority. The parent/guardian of a child with a disability must request special meals and provide a licensed medical authority’s signed statement that includes:

� The child’s disability and an explanation of why the disability restricts the child’s diet;

� The major life activity affected by the disability;

� The foods that must not be served to the child; and

� The foods that must be substituted.

Important! Some children may have difficulty chewing and swallowing and may require softer foods, such as cooked rather than raw carrots or foods that have been chopped, ground, or blended from their original form. These modifications can usually be made within the meal pattern requirement. A medical authority’s written instructions indicating food texture is recommended, but not required.



Meals for Children with Special Dietary Needs

Children who are not disabled but have certified medical or special dietary needs may be served substitutions. This includes children with food intolerance, for example, lactose intolerance.

The parent/guardian of the child must provide a licensed medical authority's signed statement that includes the following:

� The medical or dietary need that restricts the child’s diet; � The foods that must not be served to the child; and

� The foods that must be substituted.

If a DCH provider chooses to provide substitutions for children with medical or special dietary needs, then the provider must:

� Provide substitutions on a case-by-case basis; � Maintain the medical documentation in your files;

� Provide a copy of the required medical statement to you;

Provide the meals at no additional cost to the child; and

� Document all substitutions made to meals on separate meal

production records (Form H1539 or Form H1530-A).

Fluid Milk Substitutions Children who cannot consume fluid milk due to medical or other special dietary needs, other than a disability, may be served non-dairy beverages in lieu of fluid milk. Non-dairy beverages must be nutritionally equivalent to milk and meet the nutritional standards for fortification of calcium, protein, vitamin A, vitamin D and other nutrients to levels found in cow’s milk as outlined in the handbook.



Parents or guardians may request in writing non-dairy substitutions without providing a medical statement. You must ensure the substitution meets the requirements. The written request from the parent or guardian must identify the medical or special dietary need that restricts the diet of the child. For example, a parent who has a child who follows a vegan diet may request soy milk be served instead of cow’s milk. Milk substitutions are at the option and expense of the provider. Product Labeled Food Commercially prepared foods, including those prepared by restaurant, “fast food” outlets, etc, must:

� Have a child nutrition (CN) label; or � Be accompanied by a product formulation statement from

the food manufacturer. Foods without these forms of labeling will not meet the requirements for being reimbursable.

A Child Nutrition “CN” Label

The CN label shown below is an actual reproduction of a CN label for commercially prepared pizza.



CN labels always show:

� The CN logo on each side of the label; � A six-digit product identification number in the upper right

hand corner;

� A statement toward the product’s contribution toward the meal pattern requirements;

� A statement specifying that the use of the CN label is USDA

authorized; and

� The month and year the label was approved by USDA.



Product Formulation Statements Product formulation statements can be used for items not found in the Food Buying Guide (FBG) and for products that do not have a CN label to document the product’s contribution toward meeting the meal pattern requirements. Currently there are two available sample product formulation statements that have been developed to assist sponsors when documenting the creditable amount of food in products to meet meal pattern requirements. Both samples are located in Section 11000, Resources of your CACFP DCH Handbook:

• 11561, Prepared Grain/Bread • 11562, Meat/Meat Alternates There are detailed examples and checklists to assist you in documenting the product correctly. You may want to ask for assistance from your Community Operations office.



Meal Service Styles

Your providers may serve meals

� as a unit (cafeteria style), or � family style.

In either type of meal service style, the provider must ensure that at least the minimum quantities of each meal component are available to each child. (Remember… the minimum portion sizes are listed on the meal patterns for each meal type.) In family-style meal service:

� A sufficient amount of prepared food must be placed on each table to provide the full required portions of each of the food components for all children at the table (and any adults if they eat with the children);

� Children should initially be offered the full required portion

of each meal component. Family style meal service allows children to make choices in selecting foods and size of initial servings;

� Providers are responsible for actively encouraging children

to accept the full required portion of each food component; and

� Any second meals served are not reimbursable.



Meal Types and Service Limits Your providers may serve any or all of the following meal types:

� Breakfast; � A.M. snack; � Lunch; � P.M. snack; � Supper; and � Evening snack

You may claim reimbursement for a maximum of:

� Two meals and one snack; or

� Two snacks and one meal per child per day. All meals must meet meal pattern requirements and must be:

� Served to properly enrolled participating children; � Eaten in the facility;

� Served to children who meet CACFP age requirements; and

� Be supplied by the provider.

Non-reimbursable Meals You cannot claim reimbursement for meals or snacks:

� Served to adults;

� Served to children in excess of the provider’s licensed

capacity;

� Served to children not properly enrolled;



Non-reimbursable Meals (cont’d)

� Served to the provider’s own children, including foster

children, (during regular school hours) unless the children are home schooled and all CACFP requirements are met;

� Served to the provider’s own child, unless a non-resident

child is participating in the meal service; or

� Served to the provider’s own child, unless the child is eligible for free or reduced-price meals.

Second Meals During One Meal Service Your providers should plan and prepare their meal services with the intent of serving no more than one of each meal type per child per day. Second meals can only be claimed for reimbursement if the meal service is cafeteria style and:

� The second meals were served due to an unexpected fluctuation in participation caused by conditions beyond the provider’s control;

� The second meals meet USDA meal patterns;

� The meals were served to eligible program children;

� The provider documents justification for the second meals

served; and

� TDA F&N approves the justification due to reasons beyond the control of the provider. Quantity served is not required.



Recording Meal Services

Providers must document and record meal counts on a daily basis. Form H1539 (Day Care Home Meal Service Record) is the vehicle for provider recording of meals. You, as the sponsor, are required to supply this form to your providers. Upon receipt of the form from your providers, you must ensure that all necessary information has been entered, including:

� The date of food service; � Day of the week;

� Names of all participating, enrolled children;

� Age of each child; and

� Meals counts, by meal type, for each child.

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